The
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
requires that health plans (and healthcare providers) protect the confidentiality
and privacy of Protected Health Information (PHI). The term "Protected
Health Information" includes all information related to your past
or present health condition that individually identifies you or could
reasonably be used to identify you and is transferred to another entity
or maintained by the Plan in oral, written, electronic or any other
form. This not only includes medical records, but also includes information
regarding your eligibility for benefits under the Plan, claim status
or coverage issues regarding a particular claim and other specific information
regarding you and your dependents.

A group health plan is required to allow special enrollment
for certain individuals to enroll in the plan without having to wait
until the plan's next regular enrollment season.

Group health plans
and health insurance issuers are required to provide special enrollment
periods during which individuals who previously declined coverage for
themselves and their dependents may be allowed to enroll (without having
to wait until the plan's next open enrollment period).

A special enrollment
opportunity occurs if an individual with other health insurance loses
that coverage or if a person becomes
a new dependent through marriage,
birth, adoption or placement for adoption. However, an individual must
notify the plan of their request for special enrollment with 30 days
after losing their coverage or within 30 days of having (or becoming)
a new dependent.

A
description of your HIPAA Privacy rights is found in the Privacy Notice,
which has been distributed to you. The Privacy Notice includes the following
information:

Your
Protected Health Information (PHI)

When the Plan may disclose your PHI

When the disclosure of your PHI requires
your written authorization

Use or disclosure of your PHI that requires
you to be given an opportunity to agree or disagree before its use
or release.

Use or disclosure of your PHI for which
consent, authorization or opportunity to object is not required.

Your
Individual Privacy Rights

Requesting restrictions on PHI uses and
disclosures

Inspecting and copying PHI

Requesting that the Plan amend your PHI

Receiving an accounting of the Plan's
PHI disclosures

Exercising your rights through a personal
representative

The
Plan's Duties

Maintaining your privacy by duties and
privacy practices

Disclosing only the minimum necessary
PHI

Your
Right to File a Complaint with the Plan or the Secretary of the U.S.
Department of Health and Human Services (HHS Secretary)

If you believe that your privacy right
have been violated, you may file a complaint with a Plan's Privacy
Officer at the Fund Office or you may contact the Secretary of the
U.S. Department of Health and Human Services, Hubert H. Humphrey Building,
200 Independence Avenue, S.W., Washington, DC., 20201

If
you have any questions about your Privacy Rights under HIPAA, you may
contact the Privacy Officer at the Fund Office.

Sincerely,

The
Board of Trustees

Please
note that this is a summary of the Plan. The full plan of benefits is
contained in the formal Plan document. If there is any discrepancy between
this summary and the Plan document, the Plan document governs.